NPI | 1134460629 |
---|---|
Entity Type | Organization |
Authorized Contact | KEITH A BERGER Owner 765-649-1991 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 111N00000X Chiropractor |
363L00000X Nurse Practitioner | |
Enumeration Date | 2013-03-07 |
Last Update Date | 2013-03-07 |